Extramarital Sex Prevalence, Associated Factors, and Viral Load Among People Living With HIV/AIDS Attending the Antiretroviral Therapy (ART) Clinic in Central Hospital, Sapele, Delta State, Nigeria: A Cross-Sectional Study.

Background Risky sexual behaviors such as extramarital sex are associated with an increased risk of HIV transmission and poor treatment outcomes. Common factors such as religion, masculinity, societal norms, women's economic hardship, income, alcohol, marital conflict, and sexual dissatisfaction are associated with extramarital sex, leading to increased transmission of HIV. This study aimed to determine the prevalence of extramarital sex, associated factors, clinical stages of disease, and viral load outcomes among people living with HIV (PLHIV) Methods This was a descriptive cross-sectional study conducted among PLHIV attending the antiretroviral therapy (ART) clinic at Central Hospital, Sapele, Delta State, Nigeria. The chi-square bivariate test was used to assess the association between the dependent and independent variables, with a p-value <0.05 considered statistically significant. Odds ratios with 95% confidence intervals (CIs) were reported to indicate the strength of the associations. Results The study included a sample of 216 participants, with a mean age of 48.0 ± 12.4 years and females being 73.1% (158). The prevalence of extramarital sexual activities among PLHIV was 10.2% (22), with common reasons such as curiosity and excitement, opportunity or temptation, emotional dissatisfaction, sexual dissatisfaction, seeking revenge, and lack of intimacy stated. Almost all the participants had either an undetectable viral load result (178, 82.4%) or a result <100 copies/ml (31, 14.4%). The male respondents were found to be six times more likely to engage in extramarital sex than females (OR = 5.97; 95% CI: 2.35-15.14; p-value <0.001). Those who considered extramarital sex to be acceptable were 25 times more likely to engage in it (OR = 24.67; 95% CI: 8.43-72.15; p < 0.001). Conclusion This study provided insight into the prevalence of extramarital sex among PLHIV, their clinical characteristics, and viral load patterns. It showed that factors associated with extramarital sex include cultural, societal, and structural factors. Efforts channeled towards comprehensive sexuality education and behavioral modification will be effective in reducing risky sexual behaviors.